Unexplained Weakness: Sudden Fatigue and Possible Causes

Q: Unexplained Weakness: Sudden Fatigue and Possible Causes

Hello Mr. <br>Wang： You mentioned feeling "generalized weakness... <br>resting and lying down feels better." Your symptoms are more indicative of insufficient cerebral blood flow, leading to symptoms similar to syncope. <br>A "tilt table test" can be used to diagnose vasovagal sy

Sudden onset of generalized weakness ~ waiting for the ambulance ~ the body returns to normal ~ a troubling mystery illness?

Hello, Dr.
Jiang.
My symptoms are as follows: I often experience sudden, generalized weakness without warning, lasting about 10 to 30 minutes each time.
Resting and lying down helps, but when the symptoms are more severe, I feel so weak that it is uncomfortable, almost to the point of fainting.
I have even called for an ambulance several times.
However, when the paramedics arrive, they check my blood pressure, heart rate, blood oxygen levels, and blood sugar, all of which are normal.
The paramedics informed me that I do not need to be taken to the emergency room, but the frequent, unexpected episodes are troubling and have begun to affect my work and daily life.
I would like to ask: (1) What could this illness be? I have had regular blood tests at a major hospital and have even visited the emergency room several times, but everything has come back normal, and the cause of my temporary weakness remains undetermined.
(2) The episodes have been more frequent recently.
I recall that I was diagnosed with COVID-19 about a month ago.
Could this be related to "long COVID" symptoms? (3) If even the major hospital tests have not revealed a common cause, should I ask my doctor to arrange for further inpatient evaluation? Or would it be better to pay for a comprehensive health check-up to potentially find the cause of my generalized weakness? Thank you, doctor.

Mr. Wang, 40~49 year old female. Ask Date: 2022/06/16

Dr. Jiang Junyi reply Neurology

Hello Mr.
Wang: You mentioned feeling "generalized weakness...
resting and lying down feels better." Your symptoms are more indicative of insufficient cerebral blood flow, leading to symptoms similar to syncope.
A "tilt table test" can be used to diagnose vasovagal syncope caused by autonomic nervous system imbalance.
The principle of the tilt table test is that when the body transitions from a supine to an upright position, approximately one liter of blood is pulled from the thoracic cavity to the peripheral venous system due to gravity.
During this moment, each heartbeat undergoes various changes, and computer analysis can depict the changes in physiological parameters, allowing for an assessment and diagnosis of syncope.
It is advisable to seek a medical center that offers this type of examination, typically led by cardiologists or neurologists.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health, peace, and joy.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2022/06/16

More Info

Hello, thank you for reaching out with your concerns regarding your unexplained weakness and fatigue. It sounds like you are experiencing a distressing and frustrating situation, and I will do my best to provide you with some insights based on your symptoms and the information you've shared.

Possible Causes of Unexplained Weakness
1. Neurological Issues: Sudden weakness can sometimes be linked to neurological conditions. While you mentioned that you have undergone various tests, including blood pressure, heart rate, blood oxygen, and blood sugar checks, it may be worthwhile to consider further neurological evaluations. Conditions such as transient ischemic attacks (TIAs), seizures, or even migraines can present with sudden weakness.

2. Psychological Factors: Anxiety and panic attacks can manifest physically, leading to symptoms such as weakness, dizziness, and a feeling of impending collapse. If you have experienced significant stress or anxiety, this could be a contributing factor.
3. Cardiovascular Concerns: Although your vital signs were normal during the ambulance checks, it might be beneficial to explore potential cardiovascular issues further. Conditions like orthostatic hypotension (a drop in blood pressure when standing) or arrhythmias can cause sudden weakness.

4. Metabolic or Endocrine Disorders: Thyroid dysfunction, adrenal insufficiency, or other metabolic disorders can lead to fatigue and weakness. Even if your blood tests have returned normal, specific tests focusing on these areas might be warranted.

5. Long COVID: Given your mention of a recent COVID-19 diagnosis, it is indeed possible that you could be experiencing post-acute sequelae of SARS-CoV-2 infection (PASC), commonly referred to as "long COVID." Symptoms can include fatigue, weakness, and cognitive difficulties, and they can persist for weeks or months after the initial infection.

Next Steps
1. Consultation with Specialists: Since your symptoms are persistent and have been affecting your quality of life, I recommend consulting with a neurologist or an internist who specializes in fatigue syndromes. They may suggest further testing, including MRI or EEG, to rule out any neurological conditions.

2. Consider a Comprehensive Evaluation: If you feel that your current healthcare providers are not addressing your concerns adequately, seeking a second opinion or a comprehensive evaluation at a specialized clinic may be beneficial. Some centers focus on chronic fatigue and post-viral syndromes, which could provide more targeted care.

3. Lifestyle Modifications: While you pursue medical evaluations, consider lifestyle changes that may help manage your symptoms. Regular, gentle exercise, a balanced diet, adequate hydration, and stress management techniques such as mindfulness or cognitive behavioral therapy can be beneficial.

4. Monitoring Symptoms: Keep a detailed diary of your symptoms, including when they occur, their duration, and any potential triggers. This information can be invaluable for your healthcare providers in diagnosing and managing your condition.

5. Further Testing: If your symptoms continue to be unexplained, discussing the possibility of more advanced testing or even a comprehensive health check-up that includes metabolic panels, hormone levels, and possibly genetic testing could be worthwhile.

Conclusion
Unexplained weakness can be a complex issue with multiple potential causes. It is essential to continue advocating for your health and seeking answers. Engaging with specialists, considering the possibility of long COVID, and exploring comprehensive evaluations may lead to a better understanding of your condition. Remember, you are not alone in this, and there are healthcare professionals who can help you navigate these challenges. Please take care and keep pursuing the answers you need for your health and well-being.

Similar Q&A

Understanding Generalized Weakness: Causes and Solutions for Fatigue

Sometimes I feel weak all over, lacking energy, and very sleepy, yet I can't get enough rest. When I squat down and get up, my vision goes dark, and I feel very dizzy. What illness could I have? Please help me!

Dr. Fang Sijie reply Family Medicine
Dear Mr. Ahua, Due to the incomplete information provided, I am unable to fully address your concerns. However, I can offer a general response based on your description. You mentioned experiencing general fatigue, a lack of energy, and a strong desire to sleep, yet feeling unres...

Understanding Unexplained Fatigue: Causes and Necessary Tests

In the past six months, I have been experiencing unexplained fatigue. Even with sufficient sleep, I still feel increasingly tired after being awake for about 12 hours, as if I would collapse without sleep, which is very distressing. However, I usually get enough sleep and do not ...

Dr. Zeng Guosen reply Internal Medicine
Hello, internet user: Discomfort in individuals can be attributed to both physiological and psychological causes. You should first visit a hospital for an examination to rule out any physiological reasons for your fatigue. If everything is normal, then consider consulting a psych...

Understanding Fatigue: Causes and Solutions for Persistent Weakness

Hello, Dr. Hsiao! I am 19 years old and have a normal sleep schedule of about 8 hours. I wake up feeling well-rested, but after a while, I start to feel fatigued again. Taking a nap in the afternoon helps somewhat, but I still feel tired shortly after. Recently (over the past two...

Dr. Xiao Yongxun reply Internal Medicine
Dear Ms. Anonymous: 1. Fatigue is something that almost everyone experiences at some point in their lives, and most diseases can cause fatigue. Typically, fatigue is temporary, self-limiting, and the primary cause can often be identified. Based on the nature of the causes, fati...

Understanding Metabolism Issues: Symptoms of Muscle Cramps and Fatigue

Hello Doctor, I am experiencing symptoms such as muscle cramps and weakness in my hands and feet, frequent dizziness, and a feeling of weakness in my legs. Recently, I often forget things that just happened, have difficulty concentrating, and feel slight numbness at the corners...

Dr. Yang Hongzhi reply Internal Medicine
Your symptoms are nonspecific and do not seem to correlate with your known medical history. This situation may not necessarily lead to a diagnosis of a specific disease; however, it is advisable to visit an internal medicine outpatient clinic, as sometimes physicians can identify...